The greatest misuse of mephedrone: Using it as bath salts.

It certainly appears that the ACMD's terms of reference below have been overlooked in the hasty manner in which mephedrone's prohibition has come about.

The terms of reference of the Advisory Council are set out in section 1 of the Misuse of Drugs Act 1971(the Act) and are as follows:

It shall be the duty of the Advisory Council to keep under review the situation in the United Kingdom with respect to drugs which are being or appear to them likely to be misused and of which the misuse is having or appears to them capable of having harmful effects sufficient to constitute a social problem, and to give to any one or more of the Ministers, where either Council consider it expedient to do so or they are consulted by the Minister or Ministers in question, advice on measures (whether or not involving alteration of the law) which in the opinion of the Council ought to be taken for preventing the misuse of such drugs or dealing with social problems connected with their misuse, and in particular on measures which in the opinion of the Council, ought to be taken.

It is quite clear that the "misuse" (definition: noun: wrong or improper use; misapplication.) of mephedrone is promoted by both it's current legal status and its soon-to-be prohibited status. The ACMD set out quite clearly in their report (though whose report is it really if the members of the committee didn't see the final draft?) that mephedrone is manufactured purely for human consumption as a stimulating intoxicant. Using mephedrone as plant food or as bath salts is clearly to "misuse" mephedrone. Of greater concern of course is the fact that no advice can currently be given by vendors on the drug's safe consumption. It is clear therefore that current regulations prohibiting its sale for human consumption promote its continued misuse.

Consider now the situation after the drug's prohibition. Optimal use of mephedrone could surely be best described as the use of mephedrone which gives the user the most pleasurable experience with the minimum of unwanted side effects. Passing the manufacture, distribution and sale of mephedrone into the hands of criminals will lead to inconsistent purity and a lack of standardised, good-quality advice on safe consumption and optimal recovery. Surely it is clear then that prohibition promotes continued misuse of mephedrone?

What measures could reduce the "misuse" of mephedrone? Sale from licensed pharmacists with age restrictions; full education on health, social, and economic consequences of use before users are licensed to purchase the drug; and education programmes which encourage abstinence but yet at all times try to ensure young people are as safe as they can be no matter what choice they make.

That is the recommendation which would best satisfy the ACMD's terms of reference. If the terms of reference had been rewritten as "to quickly suggest incorporation of any emerging psychoactive drug into the existing classification scheme alongside drugs of similar effect" then the ACMD would have done well this week. This has not happened and the ACMD has failed miserably.

Not only has it failed on the action to be taken on mephedrone, but it has also identified the next potential legal drug of abuse in naphyrone or "NRG-1" as it is more commonly known. They may as well have distributed a press release stating:
"NRG-1 has potential to be the next big thing in legal highs. We know very little about it so it will remain legal for the time being. Anyone wishing to make a lot of money fast would be wise to buy lots of NRG-1 and sell it on for considerable profit."

It is utterly irresponsible to identify this drug in their report before they have detailed an appropriate response to the conveyor belt of legal highs that are passing into commmon usage in the UK. I can only hope that a "Class D" recommendation happens before we have a massively damaging public health emergency on our hands.

For more on Class D:

http://www.guardian.co.uk/commentisfree/2010/mar/17/mephedrone-class-d-solution-criminalise

“What are the alternatives? One approach would be a new class in the Misuse of Drugs Act – the class D model, adopted in New Zealand to deal with BZP. This is a holding category where drugs can be put before they are well understood: sales are limited to over-18s; the product is quality-controlled so users know what they are getting, at doses limited as far as possible to safe levels; and it comes with health education messages. Society can limit sales and collect data on use.

Manufacturers and shops that disobey these regulations are punished, and the young are protected, but not criminalised. Last summer the Advisory Council on the Misuse of Drugs, when under my chairmanship, suggested this approach in response to the growing use of spice and BZP. It was rejected, they were both made class C, and possibly as a consequence young people began to turn to mephedrone.”

Small credit where it's due on mephedrone, but should we not have a public inquiry

Okay, let's be clear. I am not a fan of the government's drug policy. I believe Gordon Brown's refusal to consider other regulatory approaches endangers this nation's health, our security, our economy and any ambitions he might have for a better society.

But I do think that some of my drug policy reform colleagues have misjudged both public opinion and the interests of public safety on the mephedrone issue. I have no reason to assume that Alan Johnson has done anything but follow the advice given to him by Les Iversen, the current chair of the ACMD. Teenagers have been taking mephedrone in alarming numbers. Whether this is due to misplaced confidence in the drug's safety due to its legality, or whether they were excited about the prospect of doing something they knew to be bad with no risk of punishment, it was essential for the government to intervene to restrict access and take action that they hope will cause these teenagers to return to drug-free lives.

And the government has got many aspects of the action right. The action to ensure destruction of any detected mephedrone imports is a strong signal that importation is now no longer viable. While traders may object on the grounds that it was legal when they ordered it, I am in no doubt that their contentment with their requirement to sell the drug without any health advice to buyers of any age could in no way be regarded as ethical. Had they been able to provide health and consumption advice and been able to do all they could to ensure their customers' safety then their trade could very well have been considered ethical. But the lack of such safety advice meant the dealers were ethically no better than the illegal dealers dealing similar illegal drugs. I would be delighted to see the expression on the faces of the dealers trying to stockpile as much mephedrone as possible before its prohibition when they learn of the destruction of their newly priceless shipment.

The government has also taken the right action (once prohibition was the decision) in banning all cathinones. Just banning mephedrone would quickly have resulted in the market shifting to any of a large number of other cathinones with a myriad of unknown effects to investigate and for society to deal with. I am unsure where drugs like butylone and the cathinone-containing plant "khat" are left by this action, but the blanket ban on cathinones seems like a wise decision at this stage.

Having said all this, I have great concern about the role the ACMD has played in this decision. The ACMD made the extremely sensible "Class D" recommendation when it was asked for advice on BZP and Spice. A "D" class would have allowed legal, regulated sale of the drug to over 18s and with the best advice available on safe use while the effects of the drug were investigated thoroughly. The recommendation was rejected for BZP and Spice. Was it offered as a solution to the mephedrone situation? If it was not then I would assert that the ACMD has lost its spine and can no longer be relied upon to stick to its guns on these important issues in the interests of public safety. To not offer the "Class D" solution is to pass responsibility for mephedrone from unregulated legal dealers to unregulated illegal dealers. Any teenager who still fancies getting hold of the mephedrone they have developed a taste for, will now have to find an illegal dealer. That dealer might just have a financial interest in introducing them to heroin or crack.

This entire episode which may become known as "the mephedrone bubble" should be seen as a disastrous warning on the failings of the Labour party's "head-in-the-sand" approach to drugs policy. All the illegal drugs consumed in this country are being consumed in an environment of government-mandated ignorance. Any new legal highs which emerge will - like mephedrone - again have to be consumed from bags marked "not for human consumption". It is time the politicians and the media in this country grew up and realised that it is ignorance and lack of regulation that makes drugs dangerous. We need to take this opportunity to learn from the mephedrone bubble and look again at what can be done to safeguard our population from the harms of drugs.

Surely it would be appropriate to call for a broad-ranging public inquiry into the drug policy disaster that is "the mephedrone bubble".